Physician Resources for Peripheral Artery Disease

Peripheral Artery Disease (PAD) results from a progressive thickening of an artery’s lining caused by a buildup of plaque, which narrows or blocks blood flow, reducing the circulation of the blood to the lower extremities or other organs and regions of the body.

People with PAD may not experience symptoms until the disease is advanced. Almost all symptoms are due to the leg muscles not having enough blood. Typically, people with PAD experience painful cramping in the hips, thighs, or calves with walking, climbing stairs or exercising that is relieved with rest. PAD is often mis or undiagnosed, which can lead to preventable loss of mobility, amputations, and even death.

What to Know:

  • One in 20 Americans over 50 has PAD[i]
  • One in 10 Americans over 70 and one in 4 Americans over 80 has PAD[ii]
  • 20-50% of PAD cases are asymptomatic[iii]
  • People with PAD have an increased risk of experiencing a heart attack or stroke
  • Risk factors for PAD include smoking, diabetes, hypertension, high cholesterol, obesity, physical inactivity, age > 65, genetic predisposition
  • Notably, patients with diabetes have an increased risk of lower-extremity amputation and higher mortality from PAD[iv]
  • Walking can help improve PAD symptoms[v],[vi]

What to Do:

  • Ask your patients about their risk factors and symptoms:  PAD Symptom Checklist for Clinicians
  • Assess patients at increased risk of PAD for exertional leg symptoms, ischemic rest pain, and nonhealing wounds. The vascular examination should include palpation of lower extremity pulses and auscultation for femoral bruits[vii]
  • Test the resting ankle-brachial index (ABI) of patients with signs or symptoms of PAD
  • Refer patients to a specialist in cardiovascular medicine if meeting criteria (ABI <1.0) Patients with limb-threatening ischemia manifested by chronic pain at rest (>2 weeks), ischemic wounds or tissue loss, or gangrene should be referred immediately to a vascular surgeon.

Resources for Physicians:

AAFP (American Academy of Family Physicians)


AHA/ACC (American Heart Association/American College of Cardiology)


APMA (American Podiatric Medical Association)


Penn Medicine


 SVS (Society for Vascular Surgery)


US Preventive Services Task Force

___________________________________________________________

  1. https://www.nhlbi.nih.gov/health/educational/pad/docs/pad_extfctsht_general_508.pdf
  2. https://www.cdc.gov/heartdisease/PAD.htm
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5077147/#R4
  4. https://pubmed.ncbi.nlm.nih.gov/26185603/
  5. https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000623
  6. https://www.pennmedicine.org/updates/blogs/heart-and-vascular-blog/2016/february/the-best-workout-to-manage-symptoms-of-peripheral-artery-disease
  7. https://www.aafp.org/afp/2019/0315/p362.html